Organization
WALMART INC.
Active
Other names
WAL-MART PHARMACY 10-5186
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
2501 S MARKET ST, GILBERT, AZ 85295-1300
(480) 224-6911
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y004196
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1991879
PK
—
05
—
914714
—
AZ
Enumeration date
07/16/2006
Last updated
06/12/2025
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